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Polmed continuation form 2026
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- Click ‘Get Form’ to open the polmed continuation form in the editor.
- Begin by filling in your Membership Number and Date at the top of the form. Ensure that you enter the date in the correct format (DD/MM/YYYY).
- In the Member Details section, provide your Surname, First Names, Title/Rank, Initials, Identity Number, Marital Status, Gender, and Date of Marriage/Divorce if applicable.
- Complete your Residential and Postal Address details. Indicate how you wish to receive correspondence by selecting Email, SMS, or Postal Address.
- Fill out the Membership Type section by selecting from options such as Pensioner or Medically Boarded. Include relevant dates where required.
- In the Details of Dependant(s) section, list each dependant's Surname, Full First Name, ID Number, Relationship to you, and Gender.
- Provide your Banking Account Details for direct crediting and debiting. Ensure accuracy to avoid payment issues.
- Review the POPI Consent section carefully and select YES or NO for each statement regarding sharing personal health information.
- Finally, complete the Consent & Declaration section by signing and dating it before submitting your application.
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polmed chronic application form 2024
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